Developing Health Sciences Students to Be Health Navigators for Diabetes Prevention and Care

Problem Description - Unhealthy behaviors contribute to major ailments in the US, particuarly diabetes. An estimated 39% of deaths in 2000 were attributed to health risk behaviors including physical inactivity and poor nutrition. Poor dietary habits and physical inactivity are major contributors to diabetes. Clinicians in primary care are ideally situated to initiate interventions for changing these risk behaviors contributing to diabetes. Unfortunately, time pressures do not currently support handling of these difficult problems. Given these realities, it is imperative that primary care practices link themselves with all available community resources to assist in the task of behavior change. This proposal provides a novel link between clinician, patient and resources - the Health Navigator. Integrating health sciences students as Health Navigators provides at minimal cost an integrative patient centered care approach as well as a new student clinical learning opportunity. Specific Aims -This proposal aims to improve Primary Care's ability to effectively assist patients in their efforts to change unhealthy behaviors, specifically physical inactivity and poor diet, as risk factors for diabetes. The specific aims of the proposal are to develop health science students (physician assistants, clinical nutritionist and physical therapists) as Health Navigators. These students would: 1. Complete a comprehensive community health resource analyses for 6 Kentucky Ambulatory Network (KAN) rural practices in coordination with their clinical AHEC rotations, 2. Based on the community health resources data, develop and maintain, with staff assistance, a comprehensive data base for health resources in these communities, 3. Facilitate the implementation of a health risk assessment (HRA) for all adult patients obtaining care at the 6 KAN rural practices within the practice based research network (PBRN), 4. Partner each practice with specialty trained Health Navigators who proactively direct patients, based on their HRA, to appropriate resources and facilities available to them in their communities or surrounding regions, 5. Construct a usable and effective loop from the HRA, to the clinician, on through the patients, Health Navigators, and community resources, back to the clinicians, and 6. Demonstrate acceptable reach, significant effectiveness, adequate adoption, full implementation, and a feasible maintenance plan for the intervention.